Van Leuvenhaege Chloé, Vandelannoote Koen, Affolabi Dissou, Portaels Françoise, Sopoh Ghislain, de Jong Bouke C, Eddyani Miriam, Meehan Conor J
Mycobacteriology unit, Department of Biomedical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Laboratoire de Référence des Mycobactéries, Cotonou, Benin.
PLoS One. 2017 Jul 27;12(7):e0181994. doi: 10.1371/journal.pone.0181994. eCollection 2017.
Buruli ulcer (BU) is an infectious disease caused by Mycobacterium ulcerans and considered the third most prevalent mycobacterial disease in humans. Secondary bacterial infections in open BU lesions are the main cause of pain, delayed healing and systemic illness, resulting in prolonged hospital stay. Thus, understanding the diversity of bacteria, termed the microbiome, in these open lesions is important for proper treatment. However, adequately studying the human microbiome in a clinical setting can prove difficult when investigating a neglected tropical skin disease due to its rarity and the setting.
METHODOLOGY/PRINCIPAL FINDINGS: Using 16S rRNA sequencing, we determined the microbial composition of 5 BU lesions, 3 non-BU lesions and 3 healthy skin samples. Although no significant differences in diversity were found between BU and non-BU lesions, the former were characterized by an increase of Bacteroidetes compared to the non-BU wounds and the BU lesions also contained significantly more obligate anaerobes. With this molecular-based study, we were also able to detect bacteria that were missed by culture-based methods in previous BU studies.
CONCLUSIONS/SIGNIFICANCE: Our study suggests that BU may lead to changes in the skin bacterial community within the lesions. However, in order to determine if such changes hold true across all BU cases and are either a cause or consequence of a specific wound environment, further microbiome studies are necessary. Such skin microbiome analysis requires large sample sizes and lesions from the same body site in many patients, both of which can be difficult for a rare disease. Our study proposes a pipeline for such studies and highlights several drawbacks that must be considered if microbiome analysis is to be utilized for neglected tropical diseases.
布鲁里溃疡（BU）是由溃疡分枝杆菌引起的一种传染病，被认为是人类中第三大常见的分枝杆菌病。开放性布鲁里溃疡病变中的继发性细菌感染是疼痛、愈合延迟和全身疾病的主要原因，导致住院时间延长。因此，了解这些开放性病变中被称为微生物群的细菌多样性对于正确治疗至关重要。然而，在临床环境中充分研究人类微生物群可能会很困难，因为在调查一种被忽视的热带皮肤病时，由于其罕见性和环境因素。
方法/主要发现：我们使用16S rRNA测序确定了5个布鲁里溃疡病变、3个非布鲁里溃疡病变和3个健康皮肤样本的微生物组成。虽然在布鲁里溃疡和非布鲁里溃疡病变之间未发现多样性的显著差异，但与非布鲁里溃疡伤口相比，前者的特点是拟杆菌门增加，并且布鲁里溃疡病变中还含有明显更多的专性厌氧菌。通过这项基于分子的研究，我们还能够检测到在先前布鲁里溃疡研究中基于培养的方法遗漏的细菌。
结论/意义：我们的研究表明，布鲁里溃疡可能导致病变内皮肤细菌群落的变化。然而，为了确定这些变化是否适用于所有布鲁里溃疡病例，以及它们是特定伤口环境的原因还是结果，还需要进一步的微生物群研究。这种皮肤微生物群分析需要大量样本以及来自许多患者同一身体部位的病变，而对于一种罕见疾病来说，这两者都可能很困难。我们的研究提出了进行此类研究的流程，并强调了如果要将微生物群分析用于被忽视的热带疾病必须考虑的几个缺点。
